• Describe the nurse’s role regarding a “do not resuscitate” (DNR) order. Patient confidentiality is a sacred trust. Involuntary detention occurs when an individual files with the court within 96 hours of the patient’s initial detention. You need to know the policies, procedures, and protocols of your employing institution so you use the same standard of care as the other nurses in your institution. Any health care professional who does not report suspected child abuse or neglect may be liable for civil or criminal legal action. Nurse experts base their opinions on existing standards of practice established by Nurse Practice Acts, professional organizations, institutional policies and procedures, federal and state hospital licensing laws, TJC standards, job descriptions, and current nursing research literature (Guido, 2010). After the newscast they received phone calls and embarrassing questions. Examples of situations that can be outlined as relating to nursing laws and ethics are numerous and diverse. Donors need to make the gift in writing with their signature. Log In or. A willful disregard by a nurse for required reporting regulations resulted in Do not disclose the patient’s confidential medical information without his or her consent. Standards of care are the legal requirements for nursing practice that describe minimum acceptable nursing care. Common law, as the term is used among lawyers in the present day, is not grounded in “custom” or "ancient usage." For example, nurses who perform illegal acts such as selling or taking controlled substances jeopardize their license status. An individual who is at least 18 years of age has the right to make an organ donation (defined as a “donation of all or part of a human body to take effect upon or after death”). Shift report. The American Association of Colleges of Nursing (AACN) supports the International Council of Nurses’ mandate to ensure an individual’s peaceful end of life (Guido, 2010). An autopsy or postmortem examination may be requested by the patient or patient’s family, as a part of an institutional policy; or it may be required by law. Exceptions to this provision include if the patient requests transfer or discharge in writing after receiving information about the benefits and risks or if a health care provider certifies that the benefits of transfer outweigh the risks. They have also upheld the right of a legally competent patient to refuse medical treatment for religious reasons. The positions of these two national organizations are not contradictory and require nurses to approach a patient’s end of life with openness to listening to the patient’s expressions of fear and to attempt to control the patient’s pain. The court held that the husband and wife stated a claim for invasion of privacy and that, even though the in vitro fertilization program was of public interest, the identity of the plaintiffs was a private matter (YG v Jewish Hospital, 1990). The standards of the profession can aid nurses comprehend professional nursing conduct by: availing a sign of the nursing practice commitment to the public; outlining the significant ethical standards for professional behaviour; guiding the professional in the quest for self-regulation; and, ensuring that nurses keep in track their unique responsibility of caring for the sick. Be familiar with the policies and procedures of your employing institution regarding organ donation. It limits who is able to access a patient’s record. Legislative amendments. Malpractice sometimes involves failing to check a patient’s identification correctly before administering blood and then giving the blood to the wrong patient. At the same time, nurses remain legally required to avail services to their clients indiscriminately. The act also protects the donor’s estate from liability for injury or damage that results from the use of the gift. • Describe the legal responsibilities and obligations of nurses regarding the following federal statutes: Americans with Disabilities Act (ADA), Emergency Medical Treatment and Active Labor Act (EMTALA), Health Insurance Portability and Accountability Act of 1996 (HIPAA), and the Patient Self-Determination Act (PSDA). Nurse Practice Acts describe and define the legal boundaries of nursing practice within each state. Examples of common law include informed consent, the patient’s right to refuse treatment, negligence, and malpractice. For example, if a driver of a car acts unreasonably in failing to stop at a stop sign, it is negligence. Community and public health nurses have the legal responsibility to enforce laws enacted to protect public health (see Chapter 3). Nursing focuses on aspects such as caring, preventing harm, and safeguarding the dignity of the client, as well as advocating the role of nurses that call for defending of the rights of clients. The patient’s injury was caused by the nurse’s failure to carry out that duty (“but for” the breach of duty, the patient would not have been injured). In a lawsuit for malpractice or nursing negligence, a nursing expert testifies to the jury about the standards of nursing care as applied to the facts of the case (Box 23-1). Nurses, especially those employed in community health settings, need to understand public health laws. Nurses who apply restraints in violation of state and federal regulations may be charged with abuse, battery, or false imprisonment. Liability for improper or unlawful restraint and for patient injury from unprotected falls lies with the nurse and the health care institution. Resources for nursing students to help with researching ethics and law. These rules create patient rights to consent to the use and disclosure of their protected health information, to inspect and copy one’s medical record, and to amend mistaken or incomplete information. For example, if a patient receives a burn from a warm compress application, negligence is determined by reviewing if the nurse followed the correct procedure for applying the compress. Regulatory law, or administrative law, reflects decisions made by administrative bodies such as State Boards of Nursing when they pass rules and regulations. These decisions form precedents (principles of law) and can then be applied in like cases. Patients who require organ transplantation are on a waiting list for an organ in their geographical area that gives priority to patients who demonstrate the greatest need. Defamation of character is the publication of false statements that result in damage to a person’s reputation. Handoff. In nursing practice this would mean that patients have the right to be respected, that they should be given the opportunity to understand and evaluate what is being asked of them and that they are provided with all the relevant Failure to Monitor One of a nurse’s main jobs is to monitor their patient, keeping track of their condition and vitals throughout the duration of their stay. For instance, in case of an emergency where a patient falls seriously ill at home, it is moral, but illegal to exceed the speed limits when driving to the hospital. QUT library has a wide range of information resources that will help you with your studies. APRN practice is typically defined by the Nurse Practice Act and governed by the Board of Nursing, but other laws and regulations may impact practice, and other boards may play a role. Statutory law is either civil or criminal. Common Examples of Malpractice in Nursing. The law is applied by reference to those previous cases, so common law is also said to be based on precedent. No actual contact is necessary. When a patient’s death has occurred under suspicious circumstances or if the patient died within 24 hours of admission to a health care facility, the decision to conduct a postmortem examination is made by the medical examiner (Autopsy Consent, 1998). A felony is a crime of a serious nature that has a penalty of imprisonment for longer than 1 year or even death. A recent study found that the most frequently occurring and stressful ethical situations are protecting patients’ rights, staffing, advanced care planning and decision-making. Be aware of legal definitions of death because you need to document all events that occur when the patient is in your care. The second situation that could be ethical rather than legal may entail allowing a patient to smoke marijuana for medicinal purposes. It is an assault for a nurse to threaten to give a patient an injection or to threaten to restrain a patient for an x-ray procedure when the patient has refused consent. Examples from the workplace will be used to guide a discussion. Define legal aspects of nurse-patient, nurse–health care provider, nurse-nurse, and nurse-employer relationships. Nursing standards of care are described in the Nurse Practice Act of every state, in the federal and state laws regulating hospitals and other health care institutions, by professional and specialty nursing organizations, and by the policies and procedures established by the health care facility where nurses work (Guido, 2010). Nurses and other healthcare professional may become entangled in either civil or criminal justice systems such as when nurses incur criminal action by failing to renew nursing license in a timely manner. Potentially suicidal patients are admitted to mental health units. 2.5 Use common legal terms associated with nursing practice with a clear understanding of their meaning and implications for nursing practice 2.6 Apply the legal requirements and expectations in relation to report writing in2.7 In one case a television crew filmed a married couple who were participating in a hospital program. In terms of individual competence, nurses are expected to practice competently and constantly attain fresh knowledge and skills within the area of practice. Other witnesses: Factual witnesses, both neutral and biased, including family members on the plaintiff’s side and other medical personnel (e.g., nurses) on the defendant’s side, are deposed to obtain information and their version of the case. Common law constantly evolves from previous decisions and changing custom. Describe the nursing implications associated with legal issues that occur in nursing practice. For instance, nurses may fail to abide by professional accountability in divulging confidential information. HIPAA privacy standards have raised awareness of the need for health care professionals to provide confidentiality and privacy. Legislative law c. Administrative law b. 1 A misdemeanor is a less serious crime that has a penalty of a fine or imprisonment for less than 1 year. Knowledge of the law of tort is important for all because most of the civil cases that resulted from nursing activities belong to the category of tort. 4. Written orders include a specific episode with start and end times. The cardiopulmonary standard requires irreversible cessation of circulatory and respiratory functions. One of the conflict that may arise between ethics and law details instances in which the nurse determines that there are no active goals that can be attained with certain services such as therapy services, then in line with the profession code of ethics it would be unethical for the practitioner to charge services rendered. Changes in Medicare and Medicaid laws and statutory recognition of nursing in advanced practice (including prescriptive authority) are examples of what type of law? Nevertheless, in some instances, the nurse’s individual rights and values may contradict the client’s right to receive care. Nurses encounter diverse situations on a day-to-day basis that may be categorized as either ethically right yet legally unacceptable, or vice versa. Each state providing for living wills has its own requirements for executing them. However, if health insurance plans provide mental health benefits, the Mental Health Parity Act of 1996 forbids health plans from placing lifetime or annual limits on mental health coverage that are less generous than those placed on medical or surgical benefits. All states have Good Samaritan laws enacted to encourage health care professionals to assist in emergencies (Dachs and Elias, 2008). These internal standards of care are specific and need to be accessible on all nursing units. Address: Cyprus Headquarters Felony is felony no matter what profession you find yourself. ). This agent makes health care treatment decisions based on the patient’s wishes (Blais et al., 2006). Society expects safe health care delivery, especially from nurses who are typically perceived as the most trusted profession. The tort of false imprisonment occurs with unjustified restraint of a person without legal warrant. against the nursing license or another denial of administrative privilege. Sometimes nurses steer away from absolute compliance, especially when the law appears as contradicting ethics. A nurse may be requested to give evidence in a deposition; this appearance needs to be taken seriously (Scott, 2009). Witnesses’ depositions: Questions are posed to the witness under oath to obtain all relevant, nonprivileged information about the case. Nurses have a specific legal obligation to treat the deceased person’s remains with dignity (see Chapter 36). When nursing care falls below a standard of care, nursing malpractice results. Protocols in these instances list specific actions that health care providers will take when providing cardiopulmonary resuscitation (CPR). One of the key principles in medicine today is evidence-based practice in nursing (EBP). He complained to the nursing staff many times. The priority for giving consent is (1) the patient in writing before death; (2) durable power of attorney; (3) surviving spouse; (4) surviving child, parent, or sibling in the order named. Throughout the years judge-made law regarding nursing practice has accumulated in the form of written opinions. Exceptions to the ability to access medical records apply to psychotherapy notes or when the health care provider has determined that access would result in harm to the patient or another party (Privacy Rights Clearinghouse, 2011). Nurses should not fear the law but instead practice nursing armed with the judgment skills that are the outcomes of informed critical thinking. COMMON LAW . I am not sure any examples can be given without doing research in the cases settled in the past. First step in this reply would be to ask a question to the questioner. This avails a platform on which varying views can be expressed, avail support for caregivers, and minimize the institutional legal risks. In addition, once you have committed to providing emergency care to a patient, you must stay with that patient until you can safely transfer his or her care to someone who can provide needed care such as emergency medical technicians (EMTs) or emergency department staff. B.American Nurses Association: “The practice of nursing means the performance for compensation of professional … To encourage reports of suspected cases, states provide legal immunity for the reporter if the report is made in good faith. In terms of conscientious objection where a certain form of care conflicts with the nurse’s moral or religious beliefs, the nurses should consult his/her employer, and do the best to refrain from providing care. The last thing a patient wants when going to a hospital for treatment is a hospital … A nurse most frequently comes into contact with the law via potential or imminent litigation in which the nurse may have engaged in, or observed in some action that led to the legal action. Common law is created through cases heard and decided in federal and state appellate courts. Litigation from improper restraint use is a common nursing legal issue (Evans and Cotter, 2008). • Discuss the nurse’s role in witnessing the informed consent process. • Failure to assess and/or monitor, including making a nursing diagnosis, • Failure to use proper equipment to monitor the patient, • Failure to notify the health care provider of problems, • Failure to follow the six rights of medication administration, • Failure to convey discharge instructions, • Failure to ensure patient safety, especially patients who have a history of falling, are heavily sedated, have disequilibrium problems, are frail, are mentally impaired, get up in the night, and are uncooperative, • Failure to follow policies and procedures, • Failure to properly delegate and supervise, Only gold members can continue reading. For example, respect the wish not to inform the patient’s family of a terminal illness. The Centers for Disease Control and Prevention (CDC) (www.CDC.gov) and the Occupational Health and Safety Act (OHSA) (www.osha.gov) provide guidelines on a national level for safe and healthy communities and work environments. Exam Mode– Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam. Nurses act as Good Samaritans by providing emergency assistance at an accident scene (Good Samaritan Act, 1997). It protects individuals from losing their health insurance when changing jobs by providing portability. For example: A parent who leaves a two-year-old child alone in the house in order to go out to a bar and have a good time could face charges for criminal negligence. Lencioni, P. (2012). Conflicts may arise when the nurse faces an unreasonable burden, a personal danger, conscientious objection, and, concerns regarding individual competence. In some cases, compliance with a legal or professional obligation may appear as harmful, unjust, or otherwise invalid. Common Law is also referred to as ‘judge-made’ or case law. Some states provide administrative and judicial review of such cases after nurses have exhausted all other forms of appeal. Treating physicians’ or health care providers’ depositions: Before subsequent treating, physicians’ or health care providers’ depositions are taken to establish issues such as those concerning preexisting conditions, causation, the nature and extent of injuries, and permanency. Nicosia 1065 As such, nurses should: determine the facts and highlight the dilemma; clarify the dilemma; implement available options and develop a plan; and, implement the plan. It allows employees to change jobs without losing coverage as a result of preexisting coverage exclusion as long as they have had 12 months of continuous group health insurance coverage (Carter, 2010). A judge makes the determination of legal competency, and the health care provider and family usually make the determination of decisional capacity. However, several cases have held that the health care provider has to disclose the fact that he or she has HIV. Answer: The nurse admits or denies each allegation in the petition. Nurses have been prosecuted for crimes such as negligent homicide, man-slaughter, theft of narcotics, insurance fraud, and falsifying medical records. Living wills are often difficult to interpret and not clinically specific in unforeseen circumstances. The health care provider who certifies death is not involved in the removal or transplantation of organs (see Chapter 36). Nurses should distinguish between law and morality since an action can be legal but immoral. 1 Contract law does not involve the law of torts but rather is created by agreement of the parties to a written or oral agreement. Examples of such laws include malpractice, invasion of privacy, assault, battery, libel, slander, and false imprisonment. The court held that the husband and wife stated a claim for invasion of privacy and that, even though the in vitro fertilization program was of public interest, the identity of the plaintiffs was a private matter (, Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on Legal Implications in Nursing Practice. Three states (Louisiana, Minnesota, and Vermont) have enacted “failure-to-act” laws that make it a crime not to provide Good Samaritan care (Dachs and Elias, 2008). An example of criminal conduct for nurses is misuse of a controlled substance. An example of a legal definition states as follows: "Abandoning or neglecting a patient or client under and in need of immediate professional care, without making reasonable arrangements for the continuation of such care, or abandoning a professional employment by a group practice, hospital, clinic or other health care facility, without reasonable notice and under circumstances which seriously impair the delivery of … The law establishes the standard of care for the protection of others against an unreasonably great risk of harm (Garner, 2006). Conversely, in some instances, the government may disallow nurses from attending to certain people or practicing in a certain way. It’s most common to allege that a nurse didn’t follow the appropriate standard of care The man’s toes became swollen and discolored, and he developed decreased sensation. The Oregon Death with Dignity Act (1994) was the first statute that permitted physician or health care provider–assisted suicide. Because a license is a property right, the State Board has to follow due process before revoking or suspending a license. The nurse did not carry out the duty or breached it (failure to use the degree of skill and learning ordinarily used under the same or similar circumstances by members of his or her profession). There are insufficient guidelines in resolving the dilemmas prominent in nursing practice. The statute stated that a competent individual with a terminal disease could make an oral and written request for medication to end his or her life in a humane and dignified manner. Even though the nurses attempted to contact the physician, this case holds that, when the physician fails to respond, the nurse must go over the health care provider’s head to make sure that he or she is appropriately treated. Scope of practice. Experts: The plaintiff selects experts to establish the essential legal elements of the case against the defendant. Almost every state uses this 1965 Illinois Supreme Court case as legal precedence. Nurses should apply the principles to practice in making ethical decisions by recognizing the client’s right to safe, competent, and ethical care. You are suing the driver who was intoxicated when the accident happened. 58-31b-102(12)(f)). Under the act the patient’s record needs to document whether or not the patient has signed an advance directive. List sources for standards of care for nurses. Two recent reforms are to mandatory reporting and statutory offences through the Health Practitioner Regulation National Law and Other Legislation Amendment Act 2019 (), which was passed by the Queensland Parliament in February 2019.The amendments include revisions to the National Law mandatory … It is not the nurse’s responsibility to decide independently the legality of disclosing information. The Joint Commission (TJC) (2011a) requires accredited hospitals to have written nursing policies and procedures. (An example is the requirements to report incompetent or unethical nurshing condcut to the state board of nursing) Common law laws that are a result from judicial decisions made in courts when individual legal cases are decided (examples: infromed consent, negligence and malpractice) Health care information privacy is also protected by standards set by the Health Care Financing Administration (HCFA) for hospitals and health care providers who participate in Medicare and Medicaid (Guido, 2010). Flat M2 Chapter 8 Legal Issues MULTIPLE CHOICE 1. Handover. Message boards used in patients’ hospital rooms to post daily nursing care information can no longer contain information revealing the patient’s medical condition. Be familiar with the DNR protocols of your state. Text Mode– Text version of the exam. The third classification of tort is the unintentional tort, which includes negligence or malpractice. Situations such as abortion, death, and euthanasia by their pure nature may place the nurse into a dilemma. In the medical field, almost any position can be held responsible for malpractice, including doctors, nurses, EMTs and other healthcare professionals. In a malpractice lawsuit a nurse’s actual conduct is compared to nursing standards of care to determine whether the nurse acted as any reasonably prudent nurse would act under the same or similar circumstances. The couple had previously told no one but their immediate family that they were involved in the in vitro fertilization program and had received assurance that there would be no publicity or public exposure. If an emergency condition exists, the hospital is not to discharge or transfer the patient until the condition stabilizes. 1500 1700: The Most Common Nursing Errors (CPD 2) There are few cases but those that directly affected nursing policies, nursing education and nursing practice are worth examining. Issues of confidentiality and trespass to a person are minefields in practice. Nurses should abide to administrative law and statutory law regulating the nursing practice. These values remain essentially shared by the society; however, when two of the values are applicable to a situation, but supporting diverging courses of action, a conflict may arise.
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